AHIP-STYLE 2025 | Medicare Certification Practice Final
AHIP-STYLE 2025
Medicare Certification
Practice Final
90 Original Scenario-Based Questions | Answer & Rationale Directly Below Every Question
NOT an official AHIP examination, leaked exam, or official answer key.
Independent 2025 Practice Resource | Question - Answer - Rationale
, AHIP-STYLE 2025 | Medicare Certification Practice Final
Section I - Medicare Foundations & 2025 Cost Benchmarks
1. Evelyn wants to keep Original Medicare and asks which two parts form its core hospital and medical
coverage. Which answer is correct?
A. Part A and Part D
B. Part B and Part C
C. Part A and Part B
D. Part C and Part D
Answer: C - Part A and Part B
Rationale: Original Medicare consists of Part A (hospital insurance) and Part B (medical insurance). Part C is Medicare
Advantage, while Part D provides outpatient prescription drug coverage.
2. A newly enrolled beneficiary has no income-related adjustment and asks for the standard Medicare
Part B monthly premium for 2025. What amount should the agent identify?
A. $185.00
B. $174.70
C. $257.00
D. $209.50
Answer: A - $185.00
Rationale: CMS set the standard Part B premium at $185.00 per month for 2025. The other figures are a 2024 premium
or 2025 deductible/coinsurance amounts, not the 2025 standard monthly premium.
3. Marcus has Original Medicare and has not yet met his Part B deductible in 2025. What annual
deductible applies before Medicare begins paying for many Part B services?
A. $240
B. $590
C. $1,676
D. $257
Answer: D - $257
Rationale: The 2025 Part B annual deductible is $257. The $590 figure is the maximum standard Part D deductible, and
$1,676 is the 2025 Part A inpatient hospital deductible.
4. After an inpatient admission in 2025, a beneficiary asks what Part A deductible applies for the benefit
period. Which amount is correct?
A. $1,632
B. $1,676
C. $838
D. $2,000
Answer: B - $1,676
Rationale: The Medicare Part A inpatient hospital deductible is $1,676 in 2025 and applies per benefit period. It is not an
annual prescription-drug cap or a lifetime-reserve coinsurance amount.
Independent 2025 Practice Resource | Question - Answer - Rationale
, AHIP-STYLE 2025 | Medicare Certification Practice Final
5. A beneficiary remains in a Medicare-covered inpatient hospital stay into day 70 during the same
benefit period in 2025. What daily Part A coinsurance applies for days 61 through 90?
A. $209.50 per day
B. $419 per day
C. $838 per day
D. $257 per day
Answer: B - $419 per day
Rationale: For 2025, the Part A coinsurance for hospital days 61-90 is $419 per day. The $838 amount applies to lifetime
reserve days, while $209.50 is the skilled nursing facility coinsurance for days 21-100.
6. A hospitalized beneficiary uses a lifetime reserve day in 2025. Which daily Part A coinsurance amount
should be used in the cost discussion?
A. $419 per day
B. $209.50 per day
C. $590 per day
D. $838 per day
Answer: D - $838 per day
Rationale: The 2025 lifetime reserve day coinsurance is $838 per day. This is distinct from the $419 hospital
coinsurance for days 61-90 and the SNF daily coinsurance.
7. After a qualifying hospital stay, Rosa enters a skilled nursing facility and reaches day 35 of Medicare-
covered SNF care in the same benefit period. What 2025 daily coinsurance applies for days 21 through
100?
A. $209.50 per day
B. $185.00 per day
C. $257.00 per day
D. $419.00 per day
Answer: A - $209.50 per day
Rationale: For 2025, the SNF coinsurance for days 21-100 is $209.50 per day. The other amounts correspond to the Part
B monthly premium, Part B deductible, or hospital coinsurance.
8. Thomas has fewer than 30 quarters of Medicare-covered employment and does not qualify for
premium-free Part A. Which 2025 full Part A premium is generally relevant?
A. $285 per month
B. $185 per month
C. $518 per month
D. $590 per month
Answer: C - $518 per month
Rationale: The full 2025 Part A premium is $518 per month for certain individuals with fewer than 30 quarters of
covered employment. A reduced premium of $285 applies to certain people with 30-39 quarters.
Independent 2025 Practice Resource | Question - Answer - Rationale
, AHIP-STYLE 2025 | Medicare Certification Practice Final
9. A beneficiary is choosing between Original Medicare alone and a Medicare Advantage plan because
she is concerned about catastrophic medical cost sharing. Which distinction is most important?
A. Medicare Advantage plans include a maximum out-of-pocket limit for covered Part A and Part B services;
Original Medicare alone does not have the same annual medical MOOP.
B. Original Medicare automatically limits all Part A and Part B cost sharing to $2,000 per year.
C. Part D sets the maximum out-of-pocket limit for all hospital and physician services.
D. Medigap is automatically included with every Medicare Advantage plan.
Answer: A - Medicare Advantage plans include a maximum out-of-pocket limit for covered Part A and Part B
services; Original Medicare alone does not have the same annual medical MOOP.
Rationale: Medicare Advantage plans must include a maximum out-of-pocket limit for covered Part A and Part B
services. Original Medicare by itself does not provide the same annual medical out-of-pocket cap; the $2,000 figure is a
2025 Part D drug threshold, not a medical MOOP.
10. Linda has Original Medicare and wants insurance designed to help pay some Original Medicare
deductibles, coinsurance, and copayments without replacing Original Medicare. Which product is she
describing?
A. A stand-alone Part D plan
B. A Medicare Advantage Special Needs Plan
C. A Medicare Supplement (Medigap) policy
D. A Medicare Medical Savings Account
Answer: C - A Medicare Supplement (Medigap) policy
Rationale: Medigap supplements Original Medicare by helping with certain cost-sharing amounts. It is different from
Part D drug coverage and from Medicare Advantage plans, which are an alternative way to receive Medicare benefits.
11. Jamal wants one private Medicare plan that provides his Part A and Part B benefits and also includes
Part D prescription coverage. Which option most directly fits?
A. Original Medicare plus Medigap only
B. A Medicare Advantage Prescription Drug (MA-PD) plan
C. A stand-alone PDP only
D. Part A plus a dental discount plan
Answer: B - A Medicare Advantage Prescription Drug (MA-PD) plan
Rationale: An MA-PD plan combines Medicare Advantage medical coverage with Part D prescription drug coverage. A
stand-alone PDP provides drug coverage but does not replace the way Part A and Part B benefits are delivered.
12. A client has both Medicare and Medicaid and asks about a Medicare Advantage plan specifically
designed for people who meet dual-eligibility requirements. Which plan type should be evaluated?
A. An Institutional SNP (I-SNP)
B. A Chronic Condition SNP (C-SNP)
C. A Medicare Supplement Plan G
D. A Dual-Eligible Special Needs Plan (D-SNP)
Answer: D - A Dual-Eligible Special Needs Plan (D-SNP)
Rationale: D-SNPs are Medicare Advantage Special Needs Plans designed for beneficiaries who meet the plan's Medicare
and Medicaid eligibility criteria. I-SNPs and C-SNPs use different eligibility bases.
Independent 2025 Practice Resource | Question - Answer - Rationale
AHIP-STYLE 2025
Medicare Certification
Practice Final
90 Original Scenario-Based Questions | Answer & Rationale Directly Below Every Question
NOT an official AHIP examination, leaked exam, or official answer key.
Independent 2025 Practice Resource | Question - Answer - Rationale
, AHIP-STYLE 2025 | Medicare Certification Practice Final
Section I - Medicare Foundations & 2025 Cost Benchmarks
1. Evelyn wants to keep Original Medicare and asks which two parts form its core hospital and medical
coverage. Which answer is correct?
A. Part A and Part D
B. Part B and Part C
C. Part A and Part B
D. Part C and Part D
Answer: C - Part A and Part B
Rationale: Original Medicare consists of Part A (hospital insurance) and Part B (medical insurance). Part C is Medicare
Advantage, while Part D provides outpatient prescription drug coverage.
2. A newly enrolled beneficiary has no income-related adjustment and asks for the standard Medicare
Part B monthly premium for 2025. What amount should the agent identify?
A. $185.00
B. $174.70
C. $257.00
D. $209.50
Answer: A - $185.00
Rationale: CMS set the standard Part B premium at $185.00 per month for 2025. The other figures are a 2024 premium
or 2025 deductible/coinsurance amounts, not the 2025 standard monthly premium.
3. Marcus has Original Medicare and has not yet met his Part B deductible in 2025. What annual
deductible applies before Medicare begins paying for many Part B services?
A. $240
B. $590
C. $1,676
D. $257
Answer: D - $257
Rationale: The 2025 Part B annual deductible is $257. The $590 figure is the maximum standard Part D deductible, and
$1,676 is the 2025 Part A inpatient hospital deductible.
4. After an inpatient admission in 2025, a beneficiary asks what Part A deductible applies for the benefit
period. Which amount is correct?
A. $1,632
B. $1,676
C. $838
D. $2,000
Answer: B - $1,676
Rationale: The Medicare Part A inpatient hospital deductible is $1,676 in 2025 and applies per benefit period. It is not an
annual prescription-drug cap or a lifetime-reserve coinsurance amount.
Independent 2025 Practice Resource | Question - Answer - Rationale
, AHIP-STYLE 2025 | Medicare Certification Practice Final
5. A beneficiary remains in a Medicare-covered inpatient hospital stay into day 70 during the same
benefit period in 2025. What daily Part A coinsurance applies for days 61 through 90?
A. $209.50 per day
B. $419 per day
C. $838 per day
D. $257 per day
Answer: B - $419 per day
Rationale: For 2025, the Part A coinsurance for hospital days 61-90 is $419 per day. The $838 amount applies to lifetime
reserve days, while $209.50 is the skilled nursing facility coinsurance for days 21-100.
6. A hospitalized beneficiary uses a lifetime reserve day in 2025. Which daily Part A coinsurance amount
should be used in the cost discussion?
A. $419 per day
B. $209.50 per day
C. $590 per day
D. $838 per day
Answer: D - $838 per day
Rationale: The 2025 lifetime reserve day coinsurance is $838 per day. This is distinct from the $419 hospital
coinsurance for days 61-90 and the SNF daily coinsurance.
7. After a qualifying hospital stay, Rosa enters a skilled nursing facility and reaches day 35 of Medicare-
covered SNF care in the same benefit period. What 2025 daily coinsurance applies for days 21 through
100?
A. $209.50 per day
B. $185.00 per day
C. $257.00 per day
D. $419.00 per day
Answer: A - $209.50 per day
Rationale: For 2025, the SNF coinsurance for days 21-100 is $209.50 per day. The other amounts correspond to the Part
B monthly premium, Part B deductible, or hospital coinsurance.
8. Thomas has fewer than 30 quarters of Medicare-covered employment and does not qualify for
premium-free Part A. Which 2025 full Part A premium is generally relevant?
A. $285 per month
B. $185 per month
C. $518 per month
D. $590 per month
Answer: C - $518 per month
Rationale: The full 2025 Part A premium is $518 per month for certain individuals with fewer than 30 quarters of
covered employment. A reduced premium of $285 applies to certain people with 30-39 quarters.
Independent 2025 Practice Resource | Question - Answer - Rationale
, AHIP-STYLE 2025 | Medicare Certification Practice Final
9. A beneficiary is choosing between Original Medicare alone and a Medicare Advantage plan because
she is concerned about catastrophic medical cost sharing. Which distinction is most important?
A. Medicare Advantage plans include a maximum out-of-pocket limit for covered Part A and Part B services;
Original Medicare alone does not have the same annual medical MOOP.
B. Original Medicare automatically limits all Part A and Part B cost sharing to $2,000 per year.
C. Part D sets the maximum out-of-pocket limit for all hospital and physician services.
D. Medigap is automatically included with every Medicare Advantage plan.
Answer: A - Medicare Advantage plans include a maximum out-of-pocket limit for covered Part A and Part B
services; Original Medicare alone does not have the same annual medical MOOP.
Rationale: Medicare Advantage plans must include a maximum out-of-pocket limit for covered Part A and Part B
services. Original Medicare by itself does not provide the same annual medical out-of-pocket cap; the $2,000 figure is a
2025 Part D drug threshold, not a medical MOOP.
10. Linda has Original Medicare and wants insurance designed to help pay some Original Medicare
deductibles, coinsurance, and copayments without replacing Original Medicare. Which product is she
describing?
A. A stand-alone Part D plan
B. A Medicare Advantage Special Needs Plan
C. A Medicare Supplement (Medigap) policy
D. A Medicare Medical Savings Account
Answer: C - A Medicare Supplement (Medigap) policy
Rationale: Medigap supplements Original Medicare by helping with certain cost-sharing amounts. It is different from
Part D drug coverage and from Medicare Advantage plans, which are an alternative way to receive Medicare benefits.
11. Jamal wants one private Medicare plan that provides his Part A and Part B benefits and also includes
Part D prescription coverage. Which option most directly fits?
A. Original Medicare plus Medigap only
B. A Medicare Advantage Prescription Drug (MA-PD) plan
C. A stand-alone PDP only
D. Part A plus a dental discount plan
Answer: B - A Medicare Advantage Prescription Drug (MA-PD) plan
Rationale: An MA-PD plan combines Medicare Advantage medical coverage with Part D prescription drug coverage. A
stand-alone PDP provides drug coverage but does not replace the way Part A and Part B benefits are delivered.
12. A client has both Medicare and Medicaid and asks about a Medicare Advantage plan specifically
designed for people who meet dual-eligibility requirements. Which plan type should be evaluated?
A. An Institutional SNP (I-SNP)
B. A Chronic Condition SNP (C-SNP)
C. A Medicare Supplement Plan G
D. A Dual-Eligible Special Needs Plan (D-SNP)
Answer: D - A Dual-Eligible Special Needs Plan (D-SNP)
Rationale: D-SNPs are Medicare Advantage Special Needs Plans designed for beneficiaries who meet the plan's Medicare
and Medicaid eligibility criteria. I-SNPs and C-SNPs use different eligibility bases.
Independent 2025 Practice Resource | Question - Answer - Rationale
